Medicines that prolong life – do they already exist?

When Joe Biden was US Vice President, he gave a speech on cancer research to the Pope at the Vatican. Every cancer is different, he said, so cancer control must be personalized, tailored to each patient. The pope wasn’t really impressed, he wanted a single pill that was very cheap and would cure every cancer in the world.

A US researcher stood up in the audience and said: “Your Holiness, we are researching a pill that does not need to cure cancer – because it prevents it and many other diseases of old age too!”

Metformin: A Pill Against Aging?

This researcher’s name is Nir Barzilai and he is director of the Institute for Research on Aging at the Albert Einstein College of Medicine in New York. For ten years he has been planning a large study on a diabetes drug that is tried and tested and cheap: Metformin has been on the market for 55 years, and because it is no longer patent-protected, a tablet only costs six cents. This is exactly why Barzilai has not been able to start his study to date, it is called “TAME” (Targeting Aging with Metformin).

If it turns out that metformin can actually prevent many diseases of old age, then nobody would really make money from it, because everyone could manufacture it. Therefore, the approximately 65 million dollars for the study must be raised by donors. Now the time has finally come: Barzilai can start.

“TAME” study to prove effectiveness

He wants to administer metformin – or a dummy drug – to 3,000 people between the ages of 65 and 79 who are at high risk of cancer, heart disease or dementia for six years and then investigate whether age-related diseases occur significantly less in those who took metformin.

But why is Barzilai on a diabetes drug? Because there are already many studies showing that metformin has various protective effects: lower risk of cancer, less heart disease and dementia and much more. That’s why many healthy people are already taking metformin, even though the large study hasn’t even started yet.

Attention: The cheap pill can have side effects, cause gastrointestinal problems, it is a vitamin B12 robber – and patients with kidney disease must avoid it. And: New studies on worms and mice have revealed something unfavorable: in older animals, metformin had exactly the opposite effect. They died earlier! Well, the “TAME” study is worth its weight in gold, we are eagerly awaiting its results.

Senolytics to combat zombie cells

Luckily, there are other hopefuls in pill form. Senolytica, for example, are drugs that kill zombie cells in our organs because they are of no use other than triggering inflammation.

Companies that develop such drugs have a much easier time attracting millions of investors because of the lure of hefty profits. The longevity pills can be patented and therefore cannot be copied. Unfortunately, it will be a while before this type of pill can hit the market.

Beacon of hope rapamycin

But the greatest beacon of hope is rapamycin. It has similar effects to metformin, it puts the body into “fasting mode,” into “conservation mode,” but it works differently than metformin — and appears to be significantly stronger. Mice lived up to 60 percent longer!

But the rapamycin thing has its catches. The biggest: Rapamycin is an immunosuppressor. It prevents the immune system from rejecting foreign cells, so it is given in high doses for kidney transplants. And it has side effects.

However, when taken briefly and in low doses, it seems inflammation, prevent cancer, heart disease, and other horrors of aging—at least in mice! Because rapamycin is also no longer patent protected, companies are now developing “rapalogs” that have fewer side effects and attract high profits.

An important study is underway in the USA: with dogs! You must be at least seven years old, weigh over 40 kilos and be in good health. Large breeds age faster than small ones, so it will be easier to test whether rapamycin is working. Matt Kaeberlein from the University of Washington cannot complain about a lack of participation. The hope that the beloved four-legged friend could perhaps live three years longer than the breed average brought 600 large dogs to his “Dog Aging Project” in no time. The first results are to be published in 2026.

And a pill highlight at the end: Studies with rapamycin AND metformin as a combination pack have worked surprisingly well to prolong life – on mice …

This article first appeared in the My life print edition 05/2023.

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